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  • Title: Protective effect of free-radical scavengers on corneal endothelial damage in phacoemulsification.
    Author: Nemet AY, Assia EI, Meyerstein D, Meyerstein N, Gedanken A, Topaz M.
    Journal: J Cataract Refract Surg; 2007 Feb; 33(2):310-5. PubMed ID: 17276276.
    Abstract:
    PURPOSE: To examine the role of the water-soluble antioxidants glutathione and ascorbic acid in the irrigating solution on corneal endothelial cells following exposure to high-intensity ultrasound energy. SETTING: Goldschleger Eye Research Institute, Sheba Medical Center, Tel-Aviv University, Tel Aviv, Israel. METHODS: Thirty-two rabbit eyes were subjected to prolonged exposure to the phacoemulsification device in the anterior chamber. The eyes were divided into 4 groups that differed only in the composition of the irrigating solution applied to the eyes: balanced salt solution (BSS) BSS Plus BSS containing additional soluble components including glutathione, BSS with 10(-3) M of oxidized glutathione (GSSG), and BSS with 10(-2) M of ascorbic acid. Specular microscopy was performed preoperatively and 1 week after surgery. RESULTS: The BSS group exhibited the highest endothelial cell loss (19.3%), followed by the BSS Plus group (10.6%), the GSSG group (5.2%), and the ascorbic acid group (0.9%). An overall difference was found between the groups (F = 11.046, P<.0001), and all groups demonstrated a statistically significant difference from the control BSS group (P<.02, P = .001, and P<.0001, respectively). CONCLUSIONS: Damage to the cornea is largely due to the free radicals generated by high-intensity ultrasound energy during phacoemulsification. Adding the antioxidants ascorbic acid and GSSG to the irrigation solution significantly reduced the endothelial corneal cell damage. Ascorbic acid in the concentration of 10(-2) M had the highest protective effect; thus, it should be evaluated for clinical use.
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